A common treatment for a blocked artery, especially a coronary artery, is PTCA, in which a balloon is inflated inside the lumen of the artery, causing the lumen to increase, while compressing the blockage and/or forcefully expanding the artery. One problem with this method is restenosis, in which the artery responds to the PTCA procedure by inflammation and inward growth. Another problem is collapse of the wall of the artery back into its lumen.
The use of a stent attempts to help with one or both problems, by providing continual support against collapse. Restenosis may still occur and common practices are coating the stent with a material that prevents vessel growth and/or using local irradiation for the same effect. Some problems have been reported with these methods, for example, thrombosis formation.
Injection of drugs from outside the body using needle-less methods is known in the art.
US application publication 2003/0083612, the disclosure of which is incorporated herein by reference describes a needle-less device for injecting drugs from outside the body.
Injection of materials inside the body is also generally known.
T. Hirano, A. Nakagawa, H. Ohyama, H. Jokura, K. Takayama and R. Shirane “Pulsed liquid jet dissector using holmium: YAG laser—a novel neurosurgical device for brain incision without impairing” Acta Neuroehir (2003) 145: 401-406, the disclosure of which is incorporated herein by reference, describes the use of a Ho: YAG laser to evaporate water in a tube and thereby creates a forward (tube axis) plume of material.
Takayuki Hirano, MD, Makoto Komatsu, Toshiro Seaeki, Hiroshi Uenohara, Akira Takahashi, Kazuyoshi Takayama and Takashi Yoshimoto “Enhancement of Fibrinolytics With a Laser-Induced Liquid Jet” Lasers in Surgery and Medicine 29:360-368 (2001), the disclosure of which is incorporated herein by reference describes the forward injection of a thrombosis dissolving material.
U.S. Pat. No. 5,614,502 Mar. 25, 1997 “High pressure impulse transient drug delivery for the treatment of proliferative diseases” and U.S. Pat. No. 6,716,190 Apr. 6, 2004 “Device and method for the delivery and injection of therapeutic and diagnostic agents to a target site within a body”, the disclosures of which are incorporated herein by reference, describe methods of material delivery inside the body, including transvascularly.
W. J. Walker, I. M. Faireley “A simplified technique for the per catheter delivery of Isobutyl 2—Cyanoacrylate in the Embolisation of Bleeding Vessels”, Journal of Interventional Radiology 1987 2, 59-63, the disclosure of which is incorporated herein by reference, describes the injection of glue into a lumen and against walls of an artery, in order to block it.
U.S. Pat. No. 6,280,414, the disclosure of which is incorporated herein by reference describes a tube system for delivering a drug to the wall of a blood vessel.
U.S. Pat. No. 5,713,860 issued to Kaplan, the disclosure of which is incorporated herein by reference, teaches a lumen based system including a balloon to deliver medication.
U.S. Pat. No. 5,611,775, the disclosure of which is incorporated herein by reference teaches methods of delivery of therapeutic or diagnostic liquid into tissue surrounding a body lumen. The methods include providing a catheter having an expandable member with a plurality of small apertures and advancing this catheter into the body. The member is expanded to touch or approach the lumen wall. This patent teaches use of pressures in the range of 0.75 to 10 atmospheres to create a velocity of 0.5 to 15 M/s in material ejected through the apertures.
In other clinical scenarios, it is common to employ medicines or methods which are not cell type specific in order to eliminate a certain type of cell. Many chemotherapeutic agents are generally cytotoxic. Systemic administration of these compounds causes undesirable side effects such as nausea, hair loss, appetite suppression, weight loss and lethargy. In certain types of cancer, such as urinary bladder cancer, an intrabody lumen may be infused or “washed” with a chemotherapeutic agent in order to limit systemic toxic effects. In additional clinical scenarios, a mucosal layer covering cells lining a lumen reduces a potential efficacy of “washing”.